State Legislators Take On Aids

May 12, 1987

Illinois legislators are understandably anxious and determined to help curb the spread of deadly AIDS. But they need to be particularly cool-headed and savvy about acquired immune deficiency syndrome in order to sort out the most useful of the more than four dozen bills already proposed.

Given current medical knowledge and without a vaccine in the foreseeable future, AIDS can be prevented from spreading only by changing high-risk behavior. It is especially important to identify, counsel and influence those who are infected with the AIDS virus and can infect others, but have no obvious symptoms now. This is the goal legislators should keep in mind in choosing which bills to support.

In pursuit of that goal, most public health officials welcome moves that encourage individuals at risk of AIDS infection to be tested voluntarily, particularly if those who test positive are counseled about changing the behavior that could endanger others. This can be touchy and difficult, especially since the testing and behavior change are primarily for the benefit of others, not the carrier of the AIDS virus. Most of those now known to be infected are homosexuals, bisexuals or intravenous drug abusers and are skittish about anything that could result in public identification.

So public health officials are concerned that laws making testing mandatory for certain people--for example, those who go to drug-abuse centers and prenatal clinics--will turn people away. They usually support proposed laws strengthening the confidentiality of AIDS test records. But they fear that laws making it mandatory to ask for the names of sexual contacts so they can be notified of possible exposure to the AIDS virus--even on an anonymous basis--would backfire and keep AIDS carriers away from testing centers and counseling.

The House Judiciary Committee has sensibly shelved a bill to require AIDS testing of couples applying for a marriage license. Opponents point out that very few people planning marriage are at high risk for AIDS and such a requirement would not be cost-effective. Screening all hospital patients for the AIDS virus would also mean testing large numbers of extremely low-risk people at unnecessary expense.

Legislation to increase the dissemination of information about AIDS in public schools, among high-risk groups and for key state employees is worthwhile and is among the recommendations developed by a House medical advisory committee and passed by the House Human Services Committee. There should be little serious objection to calling for the teaching of sexual abstinence until marriage in school health classes. But a proposed ban on including information about homosexuality and ``safe sex`` is unrealistic;

like it or not, this is necessary information in the fight against the spread of AIDS.

How to provide medical care and other services for AIDS patients is also a difficult issue for state lawmakers. Despite sympathy for AIDS victims, legislators should be wary of passing bills to expand public-aid medical assistance or pay for drugs without clear estimates of eventual costs. Here the best guides are what the state provides for victims of other catastrophic illnesses.

It may be frustrating to legislators to realize that not every problem can be solved by passing well-intentioned laws. That`s why they must be careful, as physicians are admonished, to first do no harm. It is also why they should be cautious about proposals that are not supported by a consensus of public health officials.